Teaching Femoral Osteoplasty: Two Troughs, One Reproducible Result
John M. Kopriva, Peter M. Levin, James E. Voos, Michael J. SalataBackground:
Femoroacetabular impingement (FAI) is a common indication for arthroscopic femoral osteoplasty. Ample data support favorable outcomes with this procedure, but failure rates remain high. Modifiable risk factors for poor outcomes include both inadequate resection and overresection.
Indications:
Hip arthroscopy presents unique challenges. Teaching arthroscopic femoral osteoplasty presents even more challenges. These challenges prevent some trainees from obtaining the repetitions needed to succeed after training. We present a systematic method for not only performing the osteoplasty but also teaching it.
Technique Description:
Utilizing the insertion of the lateral vessels as a reliable landmark, a trough is created to set the resection depth. A second trough then sets the distal extent of the resection, with the area between the troughs resected. Sphericity of the femoral head is then created by carefully contouring the region between the physeal scar and the first trough.
Results:
A recent review of 63 patients undergoing hip arthroscopy for FAI found only 3 revision hip arthroscopies (4.8%), all of which were associated with a periacetabular osteotomy due to concerns for underlying dysplasia driving continued symptoms, and no cases of residual impingement. 84% reached the minimal clinically important difference for the Modified Harris Hip Score.
Discussion/Conclusion:
Utilizing reliable anatomic landmarks and separating resection depth and resection contouring into distinct steps, errors are minimized. Surgeons and trainees can efficiently and reproducibly work through the steps of this osteoplasty, with trainees building skills with each step.
Patient Consent Disclosure Statement:
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.